Organic Acids Test (OAT) – Comprehensive Urine Metabolic Test

76-Marker Urine Test for Metabolic, Nutritional & Microbial Insights

The Organic Acids Test (OAT) is a comprehensive urine-based laboratory test measuring 76 organic acids produced as part of normal human metabolism and microbial activity.

Organic acids are metabolic by-products generated through a wide range of biological processes, including energy production, nutrient metabolism, neurotransmitter metabolism and microbial activity. These compounds are ultimately excreted in urine.

Changes in organic acid levels can occur for many different reasons, including nutritional status, diet, metabolism, medication use, microbial activity and other physiological factors.

The OAT provides a broad overview of selected metabolic pathways and can be used alongside clinical history, symptoms and other investigations to help healthcare professionals assess areas such as energy metabolism, nutritional status, neurotransmitter metabolism, microbial activity, oxidative stress and oxalate metabolism.

76 markers • Urine sample • Comprehensive metabolic assessment • Laboratory report

What Does the Organic Acids Test Measure?

The OAT measures 76 organic acids across multiple metabolic pathways.

The markers are organised into several key areas:

• Microbial, yeast and bacterial metabolism

• Gut and microbial metabolism

• Mitochondrial and energy metabolism

• Fatty-acid and ketone metabolism

• Neurotransmitter metabolism

• Nutritional and vitamin-related markers

• Oxalate metabolism

• Amino-acid and related metabolism

Together, these markers provide a broad biochemical snapshot that can be considered alongside other clinical information.

What’s Included in the OAT?

Microbial, Yeast & Bacterial Markers

The OAT includes markers associated with microbial metabolism, including:

• Citramalic Acid

• 5-Hydroxymethyl-2-furoic Acid

• 3-Oxoglutaric Acid

• Furan-2,5-dicarboxylic Acid

• Furancarbonylglycine

• Tartaric Acid

• Arabinose

• HPHPA

• 4-Cresol

• DHPPA

Gut & Microbial Metabolism

• Carboxycitric Acid

• Tricarballylic Acid

• 2-Hydroxyphenylacetic Acid

• 4-Hydroxyphenylacetic Acid

• 4-Hydroxybenzoic Acid

• 4-Hydroxyhippuric Acid

• Hippuric Acid

• 3-Indoleacetic Acid

Mitochondrial & Energy Metabolism

These markers are associated with pathways involved in cellular energy production:

• Succinic Acid

• Fumaric Acid

• Malic Acid

• 2-Oxoglutaric Acid

• Aconitic Acid

• Citric Acid

• Lactic Acid

• Pyruvic Acid

• 2-Hydroxybutyric Acid

Fatty-Acid & Ketone Metabolism

• 3-Hydroxybutyric Acid

• Acetoacetic Acid

• 4-Hydroxybutyric Acid

• Ethylmalonic Acid

• Methylsuccinic Acid

• Adipic Acid

• Suberic Acid

• Sebacic Acid

Neurotransmitter Metabolism

The OAT includes metabolites associated with several neurotransmitter-related pathways:

• Homovanillic Acid (HVA)

• Vanillylmandelic Acid (VMA)

• HVA/VMA Ratio

• 5-Hydroxyindoleacetic Acid (5-HIAA)

• Quinolinic Acid

• Kynurenic Acid

• HVA/DOPAC Ratio

• Dihydroxyphenylacetic Acid (DOPAC)

Nutritional & Vitamin-Related Markers

The profile includes markers associated with several vitamins and nutrients:

• Methylmalonic Acid – Vitamin B12

• Pyridoxic Acid – Vitamin B6

• Pantothenic Acid – Vitamin B5

• Glutaric Acid – Vitamin B2/Riboflavin

• Ascorbic Acid – Vitamin C

• 3-OH-3-Methylglutaric Acid – CoQ10

• Methylcitric Acid – Biotin

• N-Acetylcysteine (NAC)

• Pyroglutamic Acid

Oxalate Metabolism

• Oxalic Acid

• Glyceric Acid

• Glycolic Acid

These markers provide information relating to aspects of oxalate metabolism.

Amino-Acid & Related Metabolism

• Orotic Acid

• 2-Hydroxyhippuric Acid

• 2-Hydroxyisovaleric Acid

• 2-Oxoisovaleric Acid

• 3-Methyl-2-oxovaleric Acid

• 2-Hydroxyisocaproic Acid

• 2-Oxoisocaproic Acid

• 2-Oxo-4-methiolbutyric Acid

• Mandelic Acid

• Phenyllactic Acid

• Phenylpyruvic Acid

• Homogentisic Acid

• 4-Hydroxyphenyllactic Acid

• N-Acetylaspartic Acid

• Malonic Acid

• 3-Methylglutaric Acid

• 3-Hydroxyglutaric Acid

• 3-Methylglutaconic Acid

• Uracil

• Thymine

• Phosphoric Acid

What Can the OAT Assess?

The Organic Acids Test provides information across several interconnected areas of metabolism.

1. Mitochondrial & Energy Metabolism

Markers including succinic acid, fumaric acid, malic acid, 2-oxoglutaric acid, aconitic acid and citric acid are involved in metabolic pathways associated with cellular energy production.

Additional markers such as lactic acid and pyruvic acid provide information relating to glycolytic and energy metabolism.

These results can help a healthcare professional assess aspects of energy metabolism in the context of the individual’s wider clinical picture.

2. Nutritional & Vitamin Status

The OAT contains markers associated with several vitamins and nutrients, including:

• Vitamin B12

• Vitamin B6

• Vitamin B5

• Vitamin B2/Riboflavin

• Vitamin C

• CoQ10

• Biotin

• N-acetylcysteine (NAC)

These markers can provide additional information to consider when assessing nutritional and metabolic status.

3. Neurotransmitter Metabolism

The test includes metabolites involved in neurotransmitter-related pathways, including:

• HVA

• VMA

• DOPAC

• 5-HIAA

• Quinolinic Acid

• Kynurenic Acid

These markers are associated with pathways involving neurotransmitter metabolism and can provide additional biochemical information for clinical consideration.

4. Microbial Metabolism

Several OAT markers are associated with microbial metabolism, including:

• Arabinose

• Citramalic Acid

• Tartaric Acid

• HPHPA

• 4-Cresol

• DHPPA

These results may be considered alongside digestive symptoms, medical history and other investigations when assessing aspects of microbial metabolism.

Importantly, an elevated or abnormal organic acid marker does not by itself establish the presence of a particular infection, yeast overgrowth or other medical condition.

5. Oxidative Stress & Detoxification-Related Pathways

The OAT includes metabolites involved in pathways related to:

• Cellular metabolism

• Antioxidant processes

• Oxidative stress

• Glutathione-related metabolism

• Detoxification-related pathways

These results can provide additional biochemical information when considered alongside other clinical findings.

6. Oxalate Metabolism

The OAT measures:

• Oxalic Acid

• Glyceric Acid

• Glycolic Acid

These markers provide information relating to aspects of oxalate metabolism and may be considered alongside dietary, nutritional and clinical information.

Who May Consider an OAT?

The Organic Acids Test may be considered as part of a broader assessment for individuals with complex, persistent or multi-system health concerns.

Testing may be discussed with a qualified healthcare professional where there are concerns relating to:

• Persistent fatigue or low energy

• Gut or digestive symptoms

• Nutritional or metabolic concerns

• Cognitive or neurological symptoms

• Mould or environmental health concerns

• Histamine or MCAS-related symptoms

• Complex or multi-system symptoms

• Concerns about microbial metabolism

• Concerns about energy metabolism or nutritional status

The OAT should not be used on its own to diagnose or explain a specific condition. Results need to be interpreted in the context of the individual’s symptoms, medical history, medications, nutritional status and other relevant investigations.

How Does the OAT Work?

The OAT requires a urine sample, collected at home according to the instructions provided with your testing kit.

Your Testing Journey

Step 1 – Order Your Test

Once your OAT has been ordered, your testing kit and collection instructions will be provided.

Step 2 – Prepare & Collect Your Sample

Follow the preparation instructions supplied with your kit. The recommended specimen is 10 mL of first-morning urine, collected before food or drink.

Step 3 – Return Your Sample

Your sample must be handled and stored according to the supplied instructions. The laboratory must receive the sample frozen.

Step 4 – Laboratory Analysis

Your specimen is sent to the laboratory for analysis.

Step 5 – Receive Your Results

Once analysis is complete, your laboratory report will be sent to you by email.

Important Preparation Information

Correct preparation is important for obtaining a useful laboratory result.

Sample Collection

• Sample: Urine

• Quantity: 10 mL

• Collection: First-morning urine

• Timing: Before food or drink

• Storage: Freeze according to the supplied instructions

• Laboratory: Mosaic Labs

• Turnaround: Approximately 1–2 weeks after the laboratory receives the sample

Foods to Avoid Before Testing

For 48 hours before sample collection, avoid the following foods and their juices:

• Apples

• Grapes, including raisins

• Pears

• Cranberries

Supplements to Avoid Before Testing

For 48 hours before collection, avoid:

• Arabinogalactan

• Echinacea

• Reishi mushrooms

• Ribose

Specific preparation requirements will be provided before your test kit is sent.

Medications & Supplements

Some medications, supplements and foods may need to be avoided for up to 3 days before testing, depending on the laboratory preparation requirements.

Do not stop prescribed medication or supplements without first discussing this with your healthcare professional.

Antibiotics

Please wait at least 48 hours after completing a course of antibiotics before collecting your sample, unless your healthcare professional advises otherwise.

Printing Requirements

A printer will be required to print the laboratory label needed to return your sample.

Postage

Our fees include postage and packaging to and from the client and Mosaic Labs.

Sample Requirements at a Glance

Foods:

• Apples

• Grapes / raisins

• Pears

• Cranberries and their juices

Supplements:

• Arabinogalactan

• Echinacea

• Reishi mushrooms

• Ribose

After antibiotics: Wait at least 48 hours after completing a course before collecting your sample, unless otherwise advised by your healthcare professional.

Understanding Your OAT Results

Your laboratory report will show your measured organic acid levels alongside the laboratory’s reference ranges.

Results outside a laboratory reference range can have several possible explanations. An individual result should therefore not be interpreted in isolation.

A healthcare professional may consider factors such as:

• Dietary patterns

• Nutritional status

• Supplement use

• Medication

• Microbial activity

• Energy metabolism

• Oxidative stress

• Other relevant medical or environmental factors

Where clinically appropriate, your healthcare professional may recommend dietary changes, nutritional support or additional investigation.

Your Results & Professional Support

Your completed laboratory report will be sent to you by email.

Human Defences does not provide clinical interpretation or medical guidance based on OAT results.

For appropriate interpretation, we recommend discussing your results with a suitably qualified healthcare professional who can consider your complete medical history, symptoms, medications, nutritional status and other relevant test results.

If you require assistance finding an appropriate healthcare professional to discuss your results, please let us know.

Frequently Asked Questions

What is an Organic Acids Test?

The Organic Acids Test (OAT) is a urine-based laboratory test that measures 76 organic acids associated with a range of metabolic, nutritional and microbial pathways.

What does the OAT test for?

The test measures organic acids associated with:

• Energy and mitochondrial metabolism

• Nutritional and vitamin-related pathways

• Neurotransmitter metabolism

• Microbial metabolism

• Fatty-acid and ketone metabolism

• Oxalate metabolism

• Amino-acid metabolism

• Oxidative stress and detoxification-related pathways

What sample is required?

The OAT requires a 10 mL first-morning urine sample, collected before food or drink.

Can I collect my sample at home?

Yes. The sample can be collected at home using the instructions supplied with your test kit.

Why does the sample need to be frozen?

The laboratory requires the specimen to arrive frozen. Follow the storage and shipping instructions supplied with your kit.

How quickly will I receive my results?

The typical laboratory turnaround is approximately 1–2 weeks after the laboratory receives your sample. Shipping time is additional.

Can the OAT diagnose gut problems or yeast overgrowth?

The OAT measures selected organic acid biomarkers associated with microbial metabolism, but individual results should not be used on their own to diagnose a specific infection, yeast overgrowth or other condition. Results should be interpreted alongside clinical history and other relevant investigations.

Can the OAT diagnose ADHD or autism?

No. The OAT is not a standalone diagnostic test for ADHD, autism or other neurodevelopmental conditions. It may provide additional metabolic information that a qualified healthcare professional can consider alongside an individual’s broader clinical assessment.

Do I need to stop my medication?

Do not stop prescribed medications without speaking to your healthcare professional. Certain medications and supplements may influence testing, so follow the preparation instructions supplied with your kit and discuss any questions with your healthcare professional.

Order Your Organic Acids Test Today

The Organic Acids Test (OAT) provides a comprehensive look at 76 organic acid markers associated with metabolic, nutritional and microbial pathways.

With convenient at-home urine collection and laboratory analysis, the OAT can provide additional biochemical information to discuss with your healthcare professional as part of a broader assessment.

Order your OAT today and gain a deeper understanding of your metabolic and nutritional profile.